TOPEKA — The Topeka and Leavenworth hospitals operated by the Department of Veterans Affairs each dropped a point on a five-star rating scale that compares the performance of VA medical centers.

Topeka’s Colmery-O’Neil VA Medical Center earned four stars and Leavenworth’s Dwight D. Eisenhower VA Medical Center obtained three stars on the Strategic Analytics for Improvement and Learning assessment in fiscal year 2016. On the 2017 report, each facility’s score declined.

“With current two (Leavenworth) and three (Topeka) star rankings, we recognize room for improvement and will continuously leverage opportunities to be the very best,” said Joseph Burks, spokesman for the VA Eastern Kansas Health Care System.

SAIL measures 25 areas, including death rate, complications, patient satisfaction, efficiency and physician capacity. It also assesses each center’s complexity level in terms of such factors as patient volume when comparing relative performance.

The Topeka VA has struggled for years with maintaining sufficient staffing levels, which have affected its emergency and psychiatric services. Administrators have grappled with a staffing shortage as recently as last weekend. Burks acknowledged that radiology tech coverage during the weekend “was presented as a challenge,” but said staff “stepped up” and service interruptions weren’t expected.

“As pertains to SAIL data, we are currently working to improve recruiting and retention of physicians and nurse practitioners to improve how rapidly we can schedule patients into clinic appointments,” Burks said.

The length of stay for hospitalized patients is one area where the Topeka and Leavenworth hospitals don’t perform as well as other VA facilities.

“We are constantly balancing the needs of our patients with ways to provide more efficient care to bring our performance more in line with other VA facilities,” Burks said.

SAIL is part of the VA’s effort to increase transparency after a 2014 report that found veterans were dying while waiting for care at a Phoenix VA center. Staff there maintained a secret list that hid the delays in care.

According to the VA’s Access to Care website, the average wait time for a new patient to be seen in primary care at the Topeka VA is 21 days, while patients wait an average of 27 days at the Leavenworth facility. New patients seeking a mental health appointment wait an average of 13 days at the Topeka VA and 15 days at the Leavenworth VA.

SAIL examined 146 VA hospitals in the U.S. Fourteen facilities received one star, while 19 earned five stars.